Kornimate/medical-research-clean huggingface dataset:
uterotonics using to reduce bleeding at cesarean section

Conditions: Postpartum Haemorrhage

Summary: postpartum haemorrhage continues to be a leading cause of maternal morbidity and mortality worldwide and that is according to the estimates of the world health organization in 1998. average blood loss during delivery progressively increases with the type of delivery, vaginal delivery (500 ml), cesarean section (1000 ml) and emergency hysterectomy (3500 ml) of blood. a reduction of operative blood loss at cesarean section has a great benefit to the patients in terms of decreased postoperative morbidity and a decrease in risks associated with blood transfusions. the routine use of oxytocin is associated with a significant reduction in the occurrence of postpartum hemorrhage. excessive blood loss as estimated by a 10% drop in the hematocrit value postdelivery or by need for blood transfusion, occurs in approximately 4% of vaginal deliveries and 6% of cesarean births. although many delivery units use oxytocin as the first line agent to prevent uterine atony at cesarean section, it may not be the ideal agent for prevention of postpartum haemorrhage especially in compromised patients with preeclampsia, cardiac disease or prolonged labor. oxytocin and specifically its preservative chlorobutanol increases the heart rate and has negative inotropic, antiplatelet and antidiuretic effects. misoprostol, a prostaglandin e1 analogue, has been shown in many studies to be an effective myometrial stimulant of the pregnant uterus which binds to prostanoid receptors. misoprostol administration, either by oral or rectal route, has been shown to be effective in prevention of postpartum haemorrhage and is considered as an effective alternative to other conventional oxytocics especially in developing countries as it is cheap and thermostable. pharmacokinetic studies suggested that the bioavailability of misoprostol after sublingual administration was higher than those after oral or vaginal administration. a few studies are now available for the use of sublingual misoprostol in the prevention of postpartum haemorrhage following vaginal delivery and have reported it as an effective and convenient route of administration. however, none of the studies conducted so far have evaluated the response of sublingual misoprostol for prevention of postpartum haemorrhage during cesarean section.


Eligibility criteria:
inclusion criteria: * gestational age 37-40 wk. * elective lower segment cesarean section. * under spinal anesthesia. exclusion criteria: * anemia (hb\> 8 g%). * multiple gestation. * antepartum hemorrhage. * poly-hydramnios. * two or more previous cesarean sections. * history of previous rupture uterus. * current or previous history of significant disease including heart disease, liver, renal disorders or known coagulopathy.
effect of thai traditional massage on bone markers

Conditions: Osteoporosis

Summary: the purpose of this study is to explore the skeletal effect of thai traditional massage by examining the changes in biochemical markers of bone turnover immediately after the massage.

each subject received thai traditional massage for 2 hours by a single masseuse.

Eligibility criteria:
inclusion criteria: * healthy thai women aged 20 to 40 years * have been massaged by thai traditional massage style exclusion criteria: * hyperparathyroidism, thyrotoxicosis, diabetes mellitus, rheumatoid arthritis, cancer * antiresorptive agent, teriparatide and glucocorticoid * swelling joints

Keywords: thai traditional massage bone formation bone resorption
iron replacement to reduce anemia during neoadjuvant chemotherapy

Conditions: Anemia

Summary: this is an open-label, single institution study evaluating the efficacy of intravenous iron sucrose monotherapy in patients with thoracic, breast, gu and gi malignancies undergoing neoadjuvant chemotherapy with the goal of undergoing surgical resection.

this is an open-label, single institution study evaluating the efficacy of intravenous iron sucrose monotherapy in patients with thoracic, breast, gu and gi malignancies undergoing neoadjuvant chemotherapy with the goal of undergoing surgical resection. the concomitant use of radiation and immunotherapy as part of the neoadjuvant protocol is allowed in this protocol. the study is designed to evaluate the efficacy of iron infusions in reducing blood transfusion frequency and improving hemoglobin levels prior to surgical intervention.

Eligibility criteria:
inclusion criteria: * male or female patients \> 18 years * patients undergoing neoadjuvant chemotherapy, including radiation and/or immunotherapy, with intent for curative surgical resection for breast, thoracic, gastrointestinal (gi) or genitourinary (gu) malignancies. * anemia defined as hgb \<10.5 g/dl during chemotherapy. * iron storage levels of ferritin \<500 ng/ml and iron saturation \<35% * ability to understand and willingness to sign a written informed consent and hipaa consent document exclusion criteria: * diagnosis of anemia at the time of cycle 1 day 1 of neoadjuvant chemotherapy, hgb \< 11.0 g/dl, uncontrolled intercurrent illness including, but not limited to, ongoing active infection, symptomatic new/exacerbated congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements * prior parenteral iron infusion in the past 4 weeks * the use of erythropoietin stimulating agents within 4 weeks unless chronic needs due to ckd * concurrent systemic infection at the time of enrollment. * known hypersensitivity to iron sucrose * pregnant or breast feeding. refer to section 4.4 for further detail. * anemia from another established etiology (i.e mds, myeloma)
phototherapy for non-responders to oral appliance therapy for obstructive sleep apnea

Conditions: Obstructive Sleep Apnea

Summary: obstructive sleep apnea (osa) is a medical condition where a person has great difficulty with breathing, or stops breathing all together, while asleep. this is a medical condition for which one of the current standard treatments is the use of a custom made dental appliance to help hold the person's airway open while asleep so that the person does not suffocate while sleeping. however, while the majority of osa patients are able to tolerate the use of oral appliance therapy (oat) for osa, some patients are incomplete responders to oat. these patients, despite having improvement, may still have a disease index above the diagnostic threshold for osa. phototherapy (laser therapy) has been used as a method to stiffen the soft palate and parts of the tongue to prevent their collapse. this is a type of cold laser therapy that does not cut/ablate tissue (similar to healing laser therapies). this has been shown to help with both snoring and can also help with osa, as soft palate and tongue collapse are common areas for where osa occurs inside the airway. a recent pilot study has shown that phototherapy on its own may be able to treat selected patients with mild, moderate, or severe osa. to our knowledge, there are no contraindications to combining phototherapy and dental sleep appliance therapy.

the purpose of this study is to determine whether phototherapy (nightlase/quiet night laser protocol) can change oral appliance therapy (oat) incomplete responders into complete responders for the treatment of obstructive sleep apnea (osa). patients who are incomplete responders to oat will become complete responders (as defined as a reduction of 50% and below 10) with the adjunctive use of phototherapy for osa. per the american academy of sleep medicine, first line treatment for osa is cpap. patients who are unable to tolerate cpap or otherwise decline cpap may be treated through oat. however, which compliance with oat is significantly greater than cpap, overall efficacy of oat is not as high as cpap. further treatment options for patients with are incomplete responders to oat are limited (other options include surgical interventions such as bariatric surgery and/or jaw surgery). the use of phototherapy for oat incomplete responders offers the possibility of changing the response pattern for these patients into complete response which may provide more complete treatment rather than partial management for their osa. data to be collected for this study will be standard data collected for dental sleep appliance therapy. this includes mandibular position (in digital impression form and as oj and ob recordings), range of motion, side effects/adverse reactions, titrations (% and number), total time required for treatment, medical history, cbct imaging, biographical data, phototherapy exposure settings, etc.

Eligibility criteria:
inclusion criteria: * diagnosed with osa * incomplete treatment with oat/mad exclusion criteria: * not diagnosed with osa * using cpap
a dose ranging study of the effect of ruxolitinib phosphate cream when applied to participants with plaque psoriasis

Conditions: Psoriasis

Summary: the study was double-blind, randomized, vehicle-controlled study with application of ruxolitinib phosphate cream or vehicle cream in participants with stable plaque psoriasis applied once daily for 12 weeks without occlusive dressings. there were 4 treatment groups anticipated to have 50 participants in each.


Eligibility criteria:
inclusion criteria: * plaque psoriasis involving up to 2 to 20% body surface area exclusion criteria: * lesions solely involving intertriginous areas, the scalp or the face * systemic therapy for their psoriasis * pustular psoriasis or erythroderma * currently on other topical agents or ultraviolet b (uvb) therapy within 2 weeks of the first dose of study medication * started or discontinued therapy within 2 months of screening with agents that can exacerbate psoriasis * receiving systemic triazole antifungals except fluconazole
effects of folfirinox and stereotactic body radiation therapy for advanced pancreatic cancer

Conditions: Pancreatic Cancer Non-resectable

Summary: this study wants to find out how safe and effective the use of folfirinox combined with stereotactic body radiation therapy )(sbrt) is for the treatment of pancreatic cancer.

the study will be a prospective, non-randomized, single center, trial to assess the effects of folirinox chemotherapy with sbrt on locally advanced, non-resectable pancreatic cancer. patients will either undergo a biopsy to confirm the diagnosis or have strong clinical suspicion of a new cancer or recurrence based on the recommendations of a multi-disciplinary gi oncology team. folfirinox with be delivered prior to sbrt for 4 cycles. restaging imaging will occur prior to sbrt delivery. sbrt will be delivered using standard stereotactic techniques to a dose of 3200cgy at 650cgy per fraction delivered over 2 weeks. additional adjuvant chemotherapy with be delivered at the physician's discretion. patients will be reassessed both clinically and radiographically at 3 months, 6 months, 9 months and 12 months post-treatment. quality of life analysis will occur at 3 month intervals after treatment. blood will be drawn for exploratory biomarker analysis at strategic timepoints during treatment and followup. following the initial imaging time points, standard surveillance will be employed with clinical assessment and imaging at 3 month intervals for the first 2 years post-treatment.

Eligibility criteria:
inclusion criteria: * age \>/= 18 years * ecog performance status 0-1 * pathologic or clinical diagnosis of a new pancreatic adenocarcinoma. a reasonable attempt should be made to make a pathologic diagnosis of malignancy. * imaging as follows: * ct scan of the chest, abdomen and pelvis with iv and oral contrast within 8 weeks of registration * whole body pet scan within 8 weeks of registration * evaluation by a surgical oncologist to determine non-resectability * negative serum pregnancy test within 2 weeks prior to registration for women of childbearing potential. * cbc/differential obtained within 14 days prior to registration with adequate bone marrow function as follows: * anc \> 1,500 cell/mm3 * platelets \> 100,000 cells/mm3 * hemoglobin \> 8.0 g/dl (transfusion to obtain this value is permissible) * additional labs within 14 days prior to registration * ca 19-9 * creatinine \<2mg/dl * bilirubin \<2mg/dl * ast and alt \< 2.5 x uln * patients must provide study specific informed consent prior to study entry. exclusion criteria: * metastatic disease as defined by the multi-disciplinary team * prior anti-cancer therapy for a pancreatic tumor * prior malignancy within the last 3 years. * pregnant women or lactating women * acquired immune deficiency syndrome (aids) based on cdc criteria. however hiv testing is not manditory for this protocol * hepatic insufficiency resulting in clinical jaundice and/or coagulation defects

Keywords: pancreatic cancer
gene expression in cumulus cells to predict pregnancy

Conditions: Infertility

Summary: the purpose of this study is to determine the performance of a genetic assay, gemart, in cumulus cells predictive of embryo viability, and pregnancy success in women undergoing in vitro fertilization (ivf). performance is defined as success rate per embryo transferred, as measured by the implantation rate of embryos transferred.


Eligibility criteria:
inclusion criteria: * aged 21-39 years * ivf cycle 1 or 2 * bmi \<35 * fertilization method: icsi and/or ivf * day 3 or day 5 embryo transfer * treatment cycle intended for single or double embryo transfer * use own oocytes, not oocyte donor * ≥ 3 embryos at final assessment * donor sperm acceptable * willing to comply with protocol and study procedures exclusion criteria: * polycystic ovarian syndrome * presence of fibroid(s): \>4 cm intramural or submucosal fibroids * history of chemotherapy or radiation to the abdomen or pelvis * use of donor oocytes * use of reinseminated oocytes * preimplantation genetic diagnosis or preimplantation genetic screening during current ivf cycle * concurrent participation in another clinical study * (male): surgically removed sperm * (male): \<5 million sperm count

Keywords: in vitro fertilization assisted reproduction pregnancy outcome cumulus cells
safety study of adult stem cells to treat patients with severe leg artery disease

Conditions: Critical Limb Ischemia; Arterial Occlusive Disease; Vascular Diseases

Summary: peripheral artery disease (pad) due to leg artery blockages can result in painful leg muscles, skin ulcers and infection due to poor blood flow. in severe forms, the only treatment may be amputation. adult stem cells injected into affected legs may cause new blood vessel formation and improve blood flow. the purpose of this study is to determine the feasibility and safety of injecting adult stem cells into the leg muscles of patients with severe pad, in an attempt to improve blood flow.

lower extremity peripheral artery disease (pad) is a common, debilitating and potentially life-threatening illness. obstructive pad can progress to limb-threatening ischemia with rest pain, ulcers, and gangrene requiring amputation unless blood flow to the ischemic limb can be restored. surgical revascularization options are often limited by arteries that are too small to bypass. patient co-morbidities also make surgical options risky. percutaneous revascularization techniques are similarly limited by small distal artery caliber, technical difficulty and high restenosis rates. amputation may be the only treatment option for non-healing ulcers or gangrene. direct intramuscular injection of adult stem cells may result in improved lower extremity perfusion, symptomatic improvement and limb salvage in patients with critical limb ischemia not optimal for conventional revascularization. this study aims to demonstrate the safety and feasibility of this therapeutic approach.

Eligibility criteria:
inclusion criteria: * ambulatory critical limb ischemia (rutherford score 4/5) * not optimal for surgical or catheter-based revascularization * obstructive atherosclerosis of at least 1 major artery in both limbs * ankle-brachial index \<0.6 or absolute ankle pressure \<60mmhg or toe pressure \<40mmhg or pulse volume recording that is flat or barely pulsatile exclusion criteria: * gangrene(rutherford 6) or pre-existing major tissue loss * unstable angina, mi, stroke, chf (class iii or iv) within 6 months of study treatment

Keywords: arterial occlusive diseases vascular disease
biomarkers in phototherapy of barrett's esophagus

Conditions: Barrett's Esophagus; High Grade Dysplasia

Summary: this study is being done to find out if photodynamic therapy (treatment with a red light and a drug called photofrin) or radiofrequency ablation works the same for patients who have biomarkers (abnormalities in molecules of cells that may or may not help predict cancer) present in their barrett's esophagus as for patients who do not have biomarkers.


Eligibility criteria:
inclusion criteria: * all patients will have biopsy proven barrett's esophagus with evidence of specialized intestinal epithelium and dysplasia (either high grade dysplasia or low grade dysplasia) on histology. * patients must have endoscopically visible segments of barrett's esophagus of greater than 1 centimeter in length. * all patients must be eligible for longterm follow-up as well as tolerate endoscopy, biopsy, and cytology. * patients must be willing to travel to rochester, minnesota for follow-up * patients must have a friend or relative accompany them on visits since sedatives will render them unable to operate a motor vehicle * if patients are on anticoagulation, they must be able to tolerate reversal of anticoagulation for study biopsies and therapy * all patients must be able to tolerate proton pump inhibitor therapy. esomeprazole will be provided but can be changed to another proton pump inhibitor if the patient is intolerant. * all patients who have histological or cytological evidence of high grade dysplasia will be seen by an experienced thoracic surgeon for consideration of esophagectomy. exclusion criteria: * patients who are unable to follow light avoidance instructions * patients with a history of prior esophageal surgery or successful fundoplication * patients who had prior photodynamic therapy * patients with pre-existing strictures in their esophagus * patients who have known allergies to porphyrin compounds * patients with a prior biopsies of barrett's esophagus that contain carcinoma * patients who require continuous anti-coagulation * patients who are pregnant or are capable of pregnancy will be excluded from this study unless they have been on effective birth control measures * lactating mothers are excluded from this study as it is unclear whether the photosensitizer sodium porfimer can cross to the feeding infant * patients with underlying liver disease are excluded since their metabolism of porphyrin based photosensitizers is uncertain. evidence of liver disease will be an transaminase elevation of three times normal, a bilirubin increase of twice normal, or an alkaline phosphatase (liver fraction) elevation of twice normal. * patients who have underlying medical conditions that are felt to limit their survival to less than one year.

Keywords: barrett's esophagus high grade dysplasia photodynamic therapy
effects of individualized rtms in doc patients

Conditions: Disorder of Consciousness; Transcranial Magnetic Stimulation

Summary: background: disorder of consciousness(doc) is a series of arousal and cognitive disorders secondary to the most severe brain injury. once a patient is diagnosed with a doc, a poor prognosis is assumed and the rehabilitation for whom is greatly limited. therefore, the treatment of doc poses extraordinary challenges. various treatments protocols have been reported of successful in promoting rehabilitation of doc patients. repetitive transcranial magnetic stimulation(rtms), as a non-invasive brain stimulation technique, has shown potentials for consciousness rehabilitation of doc patients as it is effective in regulating the central nervous system. methods and design: this protocol is a double-blind randomized sham-controlled crossover trial. totally 30 participants will be randomly assigned to either group 1 or group 2 in a 1:1 ratio, with 15 patients in each group. each patient will received 20 sessions, in which 10 sessions will be active and 10 will be sham, separated by 10-days washout period. the active-rtms will include 10 hz rtms over the individual-targeted area on each participants. primary and secondary evaluating indicators will be performed at each baseline and after rtms treatment. primary outcome will be determined as behavioral response to treatment as measured using the coma recovery scale - revised (crs-r). resting-state high-density eeg will be also recorded to investigate the neurophysiological correlates by rtms. discussion:this study will contribute to define the role of rtms for the treatment of doc patients and characterise the neural correlates of its action. the investigators proposed a method of individualized target selection for doc patients based on the existing gold standard crs-r score and mri, and used a cross randomized controlled trial to verify the role of rtms in doc treatment.


Eligibility criteria:
inclusion criteria: 1. acquired brain injuries less than 1 year and more than 28 days in doc; 2. clinical diagnosis of doc disease; 3. no medical history of neuropsychiatric diseases; 4. no contraindications for rtms or eeg, no sedatives in use or other drugs that might interfere with brain stimulation, such as na+ or ca2+ channel blockers or nmda receptor antagonists; 5. stable state of disease and vital signs; 6. the families of the patients volunteered the patient to participate in the study and provided signed informed consent; 7. the integrity of the individualized stimulation target cortex are verified by mri. exclusion criteria: 1. patients in other non-invasive or invasive neuroregulation trials; 2. motor evoked potential (mep) in m1 region cannot be induced by tms pulse; 3. uncontrolled epilepsy, seizure within 4 weeks before enrollment; 4. metallic implant in the skull, pacemaker, craniotomy under the stimulated site, implanted brain device.

Keywords: disorder of consciousness repetitive transcranial magnetic stimulation randomized control trial